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NPI Code Detail

MEDICARE: SUSAN WHEELDON

MEDICARE: SUSAN WHEELDON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5130-024WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619140985
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN WHEELDON
Provider Business Mailing Address
First Line : 1755 N BARKER RD
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-1801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1755 N BARKER RD
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-1801
Country : US
Telephone Number : 262-821-3939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2008
Last Update Date : 04/08/2008

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Directions to “ SUSAN WHEELDON ” Practice Location

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